MEDICARE: DAVID M LIEBERS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	170194	NY
2	207R00000X	Internal Medicine Physician	170194	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100163144729	OTHER	NY	CDPHP
2	2596519	OTHER	NY	GHI PPO
3	5379710	OTHER		AETNA
4	040426006696	OTHER	NY	FIDELIS
5	10487373	OTHER	NY	CAQH
6	32830	OTHER	NY	MVP
7	70E131	OTHER	NY	EMPIRE BLUE CROSS
8	42561	OTHER	NY	GHI HMO
9	000443021002	OTHER	NY	BLUE SHIELD
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245234905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M LIEBERS M.D.

Provider Business Mailing Address
First Line	:	1462 ERIE BLVD
Second Line	:	SUITE 2
City	:	SCHENECTADY
State	:	NY
Zip	:	12305-1026
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 NOTT ST
Second Line	:
City	:	SCHENECTADY
State	:	NY
Zip	:	12308-2425
Country	:	US
Telephone Number	:	518-243-4178
Fax Number	:	518-243-4173

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	09/11/2025

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Directions to “ DAVID M LIEBERS M.D.” Practice Location

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